- 期刊
The Loop Shoelace Technique; an Alternative Method for Closure of Fasciotomy Wounds
綁鞋帶式的皮膚牽引技術關閉筋膜切開傷口的另一種選擇
摘要
造成腔室症候群的原因非常多，大都發生在大創傷、燒傷、電傷等，在一個密閉腔室中壓力極速上昇，影響到血液循環，因缺血性反應後，進而造成神經肌肉的壞死。這是一種需要緊急開刀的手術，否則一旦延誤治療，會造成不可彌補的損失。整形外科醫師在面對這種狀況時，大都會使用皮膚筋膜切開術來釋放腔室中的壓力，以保存血管神經肌肉。若等到壓力釋放完畢，大多是很多天後的事情，這時候要關閉傷口經常有困難。有些醫師會使用植皮手術來關閉傷口，若是遇到血管神經裸露在外，皮膚移植似乎有些不宜，而且傷口不甚美觀。如果使用綁鞋帶式的皮膚牽引技術來逐步關閉筋膜切開術的傷口，不僅傷口美觀，同時也減少造成另一個傷口（供皮區）。
關鍵字
無資料並列摘要
Fasciotomy for compartment syndrome in the limb is a surgical emergency to preserve future limb function. Compartment syndrome of the extremity may occur after severe trauma secondary to fractures, vascular ischemia, crush, or electrical injury. Treatment consists of expedient fasciotomy to avoid permanent injury to muscles and nerves. Following fasciotomy in the leg, the edematous muscle and the retracted skin edges make delayed primary closure difficult. Management of the wounds after fasciotomy has consisted traditionally of primary closure, healing by secondary intention, or split-thickness skin grafting to cover defects. If the wounds are closed under too much tension, skin edge or even flap necrosis may result. The shoelace technique is a method for gradual closure of open wounds, and it appears to be effective, simpler and more economical than the other techniques described so far for the successful delayed primary closure of fasciotomy wounds.